Podcast Ep. 5 ~ Dr Swami Shankardev’s medical, yoga therapy, psychotherapy practice – interview with Ron Ehrlich

This podcast episode is from an interview with my good friend Ron Ehrlich in 2022 for his podcast Unstress. For many years Ron was also my holistic dentist. However, he has recently retired to focus more on health education. You can find out more about Ron and the wonderful work he is doing at his website Unstress Online.

In this podcast, we discuss my approach to mind-body medicine and how I incorporate meditation and Eastern and Western methods of mind-body medicine and psychotherapy into my medical and yoga therapy practice.

We discuss the history of mind-body medicine, what it is, and how relaxation is a foundation technique that enables positive changes.

I describe how both Western methods of healing and psychology and Eastern healing, psychology, and various spiritual and wisdom philosophies have defined my journey. The main focus of my approach to medicine and therapy is based on yoga and meditation as methods of connecting more to oneself, developing the power to feel, experience, and what is actually happening within the body and mind so that you can make appropriate changes and optimize your life. Meditation and psychotherapy also support you in understanding the role that illness plays in the world and that it plays in your life.

To achieve these goals, methods to cultivate self-awareness have been the foundation of everything I do.

When you are self-aware, you can strengthen your sense of self, both as an individual and as a universal being. Jungian depth psychology and Eastern approaches to psychotherapy really facilitate your ability to pierce your awareness deep into the psyche, in the dark recesses of your soul, to discover your strengths and your weaknesses, which means your humanity and how wonderful each one of us is despite our flaws.

In this podcast episode we also discuss:

• My medical journey.
• Polyvagal theory, which is a revolutionary new view of the autonomic nervous system
  
• The difference between counseling and psychotherapy
  
• What reparenting means in therapy and how we focus to develop a mature internal adult, which enables you to stand on your own two feet in life, physically, mentally, and spiritually. This means that you no longer depend so much on external sources to make decisions but have access to your own inner strengths and abilities
  
• And how I use yoga and meditation to support patients in connecting with their inner strength and ability to heal themselves.

Listen to the Interview

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Podcast Transcript ~ Episode 5

Dr. Ron Ehrlich: Hello, and welcome to Unstress. My name is Dr. Ron Ehrlich. The mind and the body are connected. Okay, that may sound obvious, but until a few years ago, the medical profession didn’t actually acknowledge how intimately that connection was. In fact, you could argue that the profession, and more importantly the public, people out there, are not aware about it as much as they should be.

My guest today is Dr. Shankardev Saraswati. He’s a medical practitioner whose practice is focused on psychotherapy. He’s also a Swami, which is a master of yoga and meditation, and he also happens to be a very good friend.

We talked about mind-body medicine. We talked about the difference between counseling and psychotherapy. We also talked about the meaning and the power of meditation and yoga. Above all, we discussed connections, and it was certainly a pleasure to connect with him, and I hope you enjoy my conversation with Dr. Shankardev Saraswati. Welcome to the show, Shankardev.

Dr. Shankardev Saraswati: Hi, Ron. Good to be here. Thanks for guiding me. It’s always good to see you.

Dr. Ron Ehrlich: Thank you. And it’s always lovely to see you, too. Now, this is … You’re a general practitioner, and you’ve been a general practitioner for some time. It’s like every practitioner, there’s a journey.

Dr. Shankardev Saraswati: 40 years.

Dr. Ron Ehrlich: 40 years. Well, sometimes 40 years, and that’s quite a bit of time. So, there’s been quite a journey, there. Can you share with us part of that journey?

Dr. Shankardev Saraswati: Well, Ron you and I have known each other for a long time, and what I enjoy from our conversations is this kind of self-reflection time, and trying to understand, actually reflect back on who I am in order to sort of talk about this with your audience. And when you asked me to come on to this podcast, it really made me think about the journey I’ve been on. Of course, you can go back a long way. I’m not going to bore you with details on that.

Dr. Ron Ehrlich: We don’t have to go back through the birthing process, but you know, they’re all relevant. I’m not dismissing them.

Dr. Shankardev Saraswati: Exactly. So, my journey’s been kind of defined by both Western healing and philosophies, and Eastern healing and philosophies, of yoga and meditation. And my name, I’m Jewish by birth, but I’ve got this Swami name, so I sort of feel that I straddled these two worlds. I think the overarching theme of my life is this straddling of the Eastern and Western systems, and that’s what I’ve tried to bring into my practice.

And I’ve never really been a classical GP. I’ve always been holistic, and even when I was in medical school when I first started to really get into yoga and meditation, the spiritual side of it, in particular, I’ve always had this kind of sense that there was a lot more to medicine than I was being taught. I remember a lot of my teachers, my cardiologist, one of the cardiologists teaching us in medical school die from a heart attack.

I remember my orthopedic surgeon who’s training me at the time told me that he had a backache, and there’s nothing he could do about his backache, and he tells all his patients, “Look, you’ve got a backache or back problem, there’s nothing you can do about it. You’ve just got to learn to live with it.”

So, that kind of mechanistic approach to the world didn’t suit. And of course, in the 70s when we were training, it was a very technically interesting time, a lot of advancement in machinery and technology, and investigations, and imaging, and all of this sort of stuff is coming out, and the human being is lost. And I think because of my personality, or something, I couldn’t fit into that model. So, I’ve always had a bit of a tense relationship with the medical system, because I felt it’s a bit rigid and a bit narrow.

But of course, now things have evolved tremendously, and now we understand the role of the person, so the bio-psycho-social models are very important. But there’s still a long way to go to address the whole person.

So, my practice has always been kind of a blending of these Eastern and Western methods, and the empowering of the individual, and trying to support people to understand the role that illness plays in the world, and that it plays in their life. And so, my practice has been really dealing with chronic illness, physical and mental illness. In the recent time, it’s become very much a psychotherapeutic practice.

But when I think about myself … When I tell my colleagues what I do, I’d say I’m a medical psychotherapist, but when I think about what I am, I’m really a yoga therapist. And the word yoga means connection, and I don’t use that word as much now because it’s been hijacked by people who do yoga therapy as a kind of postures and stretching-based practice, but for me, yoga therapy is anything in which consciousness is cultivated so that people get more awareness.

Meticulous self-awareness is the foundation of everything I do. And are then encouraged to become inquisitive, and find out more about who they are and what’s going on in their lives, in order to gain knowledge, then apply that knowledge. And it’s the yoga that makes the difference, because the yoga is the thing that enables someone to take control of their own body, mind, and to some degree, their own consciousness, spirit.

Dr. Ron Ehrlich: So, that yoga metaphor … I mean, it’s not a metaphor, it’s the connection between mind and body, is the perfect way of building practice around mind-body medicine.

Dr. Shankardev Saraswati: It is.

Dr. Ron Ehrlich: And so, a lot of people don’t fully appreciate what that actually means.

Dr. Shankardev Saraswati: Well, mind-body medicine process grew out of Herbert Benson‘s work in Harvard back in the 70s, when he did research into meditation. He was originally, for a short period time, connected to the transcendental meditation people, and then he went on to develop his own way of understanding what meditation was.

He developed what’s called the relaxation response, which was a very physiological discovery about how relaxation can retrain the system, keep the system out of the sympathetic overdrive, the stress system, down into the parasympathetic. And he then, he was in Harvard in Massachusetts, General I think it is, one of the institutions there, and he developed systems of evidence-based application of mind training, spiritual training that, along with exercise, diet, counseling, and traditional orthodox medical approaches, created this much bigger holistic system.

And it’s really that model that I think has been the foundation for a lot of the growth of mind-body medicine in the West, and that’s something that appealed to me. I met Herbert Benson back in the 80s, and I have followed his work. I think he’s done incredible work. He’s been doing research into Tibetan monks in extreme states of meditation, where they’re able to lower their oxygen saturation in their body to levels that are kind of thought to be unhealthy, as part of the hypermetabolic states they can induce. He’s measured monks that can sleep in the snow wrapped in a piece of cloth.

The mind-body medicine thing is this perfect Western corollary to yoga, in which we’re able to recognize that within us, there are things that our society has not fostered. Our knowledge-based … What we know in the world is very limited by the structures of the society we build. We create a society, and then in certain societies, they really spend a lot of time, and energy, and money on investigating human potential.

The mind, we think of the mind in a very linear, narrow way. The mind is huge, whatever that is, whatever the mind is, and there are different ways of defining that. But the potential of a human being to take control, to understand, to feel connected, to feel that they’re not powerless in the face of the world, and illness, that sort of thing, to build their own internal strengths, is enormous. And so the research is showing that we’re capable of incredible things.

Dr. Ron Ehrlich: Those instances of research which look at the extremes are great because they give us the potential that the mind actually has, but of course, there’s a whole spectrum that brings people back into their real world, what they are themselves capable of on a daily basis right now. I mean, they may not want to meditate to the point of being able to sit on a mountaintop covered by snow in a sheet –

Dr. Shankardev Saraswati: Not very useful in our society.

Dr. Ron Ehrlich: Not very useful, but interesting from the perspective of, hey, if this is what we’re capable of, what if I did a little less? God knows what I’d be capable of then.

Dr. Shankardev Saraswati: Exactly.

Dr. Ron Ehrlich: So, how does that … And again, you mention the sympathetic, which to remind our listener, is that when you’re under stress, the sympathetic nervous system is more dominant. That’s the fight or flight, and the parasympathetic is the rest and digest. How do we incorporate that into a medical practice? Or how do you incorporate that into your medical practice?

Dr. Shankardev Saraswati: Well, the work on the autonomous nervous system has grown tremendously in the past, in particular the work of Stephen Porges and his Polyvagal theory.

Dr. Ron Ehrlich: Wow, okay. Polyvagal theory. I’ll have links to that, listener. Don’t tune out just yet. We’ll get up. Go on, tell us about that.

Dr. Shankardev Saraswati: The polyvagal theory was a scientific discovery that expanded our understanding of how the nervous system works. We thought that there was basically just this dual thing. You’re either stressed, and your sympathetic system is turned on, or you’re relaxed, and your parasympathetic system is turned on.

But in fact, what we found was this third system, and what happens is that when you’re very relaxed, then a part of the vagus nerve, called the ventral vagus, I believe it’s the ventral, is turned on. And that’s the part that enables connection, that enables mindfulness, feeling grounded.

The vagus is connected to the digestive system, as well, so you have the biological, the complete cascade of biological, chemical, neurological reactions that enable digestion, that enable the absorption of nutrition into the cells, that enable the absorption of emotions into the body, that enable digestion of thinking, thoughts, knowledge, understanding. That’s where understanding comes from.

Dr. Ron Ehrlich: And the gut is also referred to as the second brain, isn’t it?

Dr. Shankardev Saraswati: It is.

Dr. Ron Ehrlich: And this is that connection.

Dr. Shankardev Saraswati: That’s a big part of it.

Dr. Ron Ehrlich: Right.

Dr. Shankardev Saraswati: That’s a big part of it. But digestion has to be thought of as physical, energetic, mental, emotional, psychic, and spiritual. Because you’ve got to be able to digest the world. You’ve got to be able to digest your experiences. So, if you’ve had a bad trauma, and that trauma’s not digested, it becomes post-traumatic stress disorder. And as soon as it’s digested, you poop out the bad stuff.

Dr. Ron Ehrlich: Yeah, no, nice metaphor.

Dr. Shankardev Saraswati: It is. Well, I use the poop metaphor a lot in my practice. It’s a powerful metaphor. It sticks.

Dr. Ron Ehrlich: Well, I like to ask, what does your poo say about you, but that’s another topic for another time. But I like this digestion, digest your trauma, digest your life events …

Dr. Shankardev Saraswati: And you poop out the bad stuff, and you absorb the lesson from what you went through. So, you can become strengthened by trauma as well.

Anyway, this polyvagal system talks about the parasympathetic, ventral, the front of the vagus nerve being this socialization. It enables us to stay in society and to relate to people from a calm place. And then if you get aroused by some threat or something you need to focus your attention, you’re driving a car, or you’re walking across the street, or you’re facing some problem, tax or something, increasing scale, then your sympathetic system has to come in, and that will give you the energy required to deal with the stress, and then you should then relax back down into that ventral vagus.

Dr. Ron Ehrlich: Ventral.

Dr. Shankardev Saraswati: The ventral vagus. But what happens is that for a lot of people, they’re stuck in the sympathetic, and then there’s another part of the vagus that deals with … that takes us into deep trauma. So, if the stresses build up a lot, then the ventral vagus is no longer accessible. The sympathetic system runs out of juice. You get adrenal fatigue, and then you fall into this next part, which is collapse, and you feel numb, trapped, helpless, lost, and you can go into states of dissociation and deep trauma.

In my practice, I see people throughout that whole range of that system, and my aim is to bring them back and cultivate the parasympathetic through relaxation and meditation, and self-introspection, and philosophy, and healing, and drugs and surgery, and everything that is required. But to get them to learn to modulate the ability to move up and down through the body-mind, to develop mind over matter, mind over body control through awareness training.

Awareness is the key. You want to have awareness, you want to feel. You want to be able to feel what’s going on. You want to be able to understand what’s going on, and then you can apply what’s appropriate to either make yourself relaxed or tense if you need to, and not allow yourself to get into these collapsed states of severe anxiety, severe depression, or the physiological correlates or parallels of that, which would be some kind of collapse of an organ system, heart, lungs –

Dr. Ron Ehrlich: A clinically-identifiable disease.

Dr. Shankardev Saraswati: Absolutely.

Dr. Ron Ehrlich: By the time you’ve got to a diagnosis … It isn’t like a light switch, one day you were really healthy and the next day you’ve got a diagnosis of some … It’s a process that we’re going through.

Dr. Shankardev Saraswati: But also, you see that if you don’t learn to regulate your own system, the stress system alone has the ability to cause illness, but if you go further if your stress system turns off, you’re in real trouble, because you’ve got nothing to fight. You’ve got no fight left. You’ve got no immunity, or your immunity’s gone crazy.

Dr. Ron Ehrlich: Yeah, which is what autoimmune conditions, happens with autoimmune conditions.

Dr. Shankardev Saraswati: Right.

Dr. Ron Ehrlich: Yeah, now, for those people that are still trying to digest that polyvagal description, I mean, the vagus nerve is very accessible by sticking your fingers down your throat and stimulating your tongue, and that’s what makes you sick. That, hey, folks, is the vagus nerve, but it’s far more complicated than that, as we’ve just heard.

Dr. Shankardev Saraswati: On that point, can I –

Dr. Ron Ehrlich: Yeah, yeah, sure.

Dr. Shankardev Saraswati: So, every morning when I brush my teeth, I rub my tongue and gag three times.

Dr. Ron Ehrlich:  Oh, dear. Yes, okay. Well, I actually … digressing here, but an overactive vagus nerve or gag reflex is often related to a cervical neck problem.

Dr. Shankardev Saraswati: Ah, interesting.

Dr. Ron Ehrlich: That’s a topic for another program. But now, you are incorporating psychotherapy into your practice. I mean, terminology-wise, is there a difference between counseling or psychotherapy?

Dr. Shankardev Saraswati: Yep.

Dr. Ron Ehrlich: Yeah, okay. What’s the difference?

Dr. Shankardev Saraswati: So, these terms are broad umbrellas, and different schools of psychology or thought will perhaps define them slightly differently, but as a broad understanding, counseling is where you want to help someone to change a behaviour. So, relaxation, change the diet, exercise, or some habit that someone that’s got in a relationship that’s getting in the way of them having a happy, successful life, or some work issues, or something, and that’s the bread and butter of psychology. CBT is very good for that.

Dr. Ron Ehrlich: CBT being?

Dr. Shankardev Saraswati: Cognitive behavioural therapy.

Dr. Ron Ehrlich: Okay.

Dr. Shankardev Saraswati: And that’s kind of the main, along with relaxation, that would be one of the main tools that a psychologist would use in dealing with behavioural issues. So, it’s all about behaviour, and the cognition that allows that behaviour to proliferate, or patterns that we’re stuck in. If we’re stuck in a pattern, how do we break the pattern and get a new pattern? Learn something a big away. That’s counseling.

Psychotherapy is a much more in-depth process, where someone either wants to change something deep in themselves, some aspect of themselves as a person or they want to grow and they want to understand more. For example, Jungian analytic psychology or psychotherapy –

Dr. Ron Ehrlich: As in Carl Jung.

Dr. Shankardev Saraswati: Carl Jung, yeah. … Is a great example of where Jung was one of these masters of the mind and enabled people to take a deep journey into themselves to discover what lies underneath, deep down.

You can think of counseling as more superficial, and psychotherapy is much more in-depth. And psychotherapy generally takes a long time. Counseling, you can do it in one session, four sessions, 10, 12 sessions, usually you can get things more or less completed. Psychotherapy, you’re looking at years.

And psychotherapy is particularly useful for people who have had major trauma, or who suffer from chronic depression, or people who have had very difficult family upbringing, those kinds of things. And then what happens is we aim to reparent the individual, support them in reparenting themselves, in order to find less internal conflict.

Dr. Ron Ehrlich: Reparenting. That’s an interesting term.

Dr. Shankardev Saraswati: Reparenting means that … Between zero and five, when you’re basically …

Dr. Ron Ehrlich: You mean five years old. Zero and five years old.

Dr. Shankardev Saraswati: Zero and five years old, thank you.

Dr. Ron Ehrlich: I thought you had a new scoring system for your … No, zero and five years old.

Dr. Shankardev Saraswati: That’s right. Keep me –

Dr. Ron Ehrlich: Keep you honest.

Dr. Shankardev Saraswati: So, between zero and five years, we’re forming an ego. We have no reference point, so we’re just absorbing the world. And so, that’s when we build these internal structures in our ego, and the aim of the outer parent is that eventually at a certain point of your life, you no longer need an outer parent, you’ve got an inner parent.

You know when it’s the right time to go to bed, you know how much to eat, how much to drink. You know how to survive in the world. You know what you can trust and what you can’t trust. And you don’t have a lot of internal conflicts about what’s right and wrong, or what should I do in my life, or how should I be?

And sometimes kids are given a message like, for example, the parents are having a lot of trouble, they’re fighting, and the kid feels very anxious and goes up to mum and says, “Mum, what’s going on?” And mum says, “Don’t worry, everything’s fine.” But the body experience of that kid is, “No, Mum’s saying … I’m getting this message that everything’s fine. I’m getting another, much bigger body message that the world’s not safe.” And so that message gets internalized and confusing.

Dr. Ron Ehrlich: Often the inner parent is under threat here, or developing –

Dr. Shankardev Saraswati: The inner parent is getting conflicting messages so that later in life, it’s very hard to know what’s going on. But the main problem with this is that you have an inner parent which keeps telling you, “There’s something wrong with me. It must be me, because Mum said the world is okay, everything is okay, but I’ve got this problem in my body, so it must be me.” So, therefore you kind of diminish yourself. You get this inner voice saying, “There’s something wrong with me, something wrong with me.”

And that’s a big part of psychotherapy, this re-establishing self-esteem, and self-efficacy, the ability to feel good about who you are, to recognize that that voice is something that you picked up at a young age that was false, no longer useful. You can do that to some degree through CBT, through cognitive behavioural therapy, but you also …

For some people, because of the pervasive nature of the trauma, or the confusion that occurred in the childhood over such a long period of time, it could be zero to 20, 20 years of this confused and conflicting stuff, then you need to go into psychotherapy, or you can go into psychotherapy.

You start to examine those patterns, and over time, you learn to deconstruct your feelings, you deconstruct your thoughts, and you learn which of those feelings are genuine and real, and which of them are old and not useful, and then you learn to digest them. You poop out as much as you can, and you take in the meaning. So, it makes us a better person. That’s the aim.

Dr. Ron Ehrlich: Now, I’ve been through this several times. I’ve had psychotherapy a couple of times in my life, and I’ve found it to be extremely useful just explaining, the process of talking to someone and articulating what is the problem. In one case, it was a grief thing.

In another case, it was a strong allergy response that hadn’t responded to anything else. I mean, I’d been through every sort of test, and in the end, I found myself in the practice of a holistic practitioner. It wasn’t you at the time. But it turned out to be two sessions, or three, or several sessions of psychotherapy about my relationship with my parents, and hey, presto, my allergies improved.

But the actual process of talking is very cathartic in itself, but then the response that comes back is very much dependent on which school that practitioner comes from. Is it?

Dr. Shankardev Saraswati: Totally, totally. And there are many different schools.

Dr. Ron Ehrlich: Many. Many, many, many different schools. And of course, that can have a profound impact on the outcome, or how comfortable you feel with your practitioner.

Dr. Shankardev Saraswati: You’ve got to shop around for the therapist.

Dr. Ron Ehrlich: Yeah, because it can … I don’t think people are necessarily aware of that, that psychotherapy is not … It’s an umbrella term, which includes many different schools. I mean, you mentioned Jung, Carl Jung, and I know Freud, and I guess that all relate back to some kind of sexual –

Dr. Shankardev Saraswati: Issue with your mother.

Dr. Ron Ehrlich: Issue with your mother.

Dr. Shankardev Saraswati: Whereas Jung was more about issues with the father.

Dr. Ron Ehrlich: Is that right?

Dr. Shankardev Saraswati: Freud had issues with his mother and good relationships with his dad, so he built his therapy around the mother archetype, mother complex.

Dr. Ron Ehrlich: Yeah.

Dr. Shankardev Saraswati: Whereas Jung had issues with his dad, and had a good relationship with his mum. He was much more into the cosmic, and the womb of life, and so on. So, the therapies form based on … Reich had a whole system.

Dr. Ron Ehrlich: What was his name?

Dr. Shankardev Saraswati: Wilhelm Reich. He built a whole system of body-oriented psychotherapy, based on the suppression of the sexual impulse. He was sort of from Freud on. And then there are multiple schools.

My approach is basically a mixture of Jungian plus so many other Western modalities. I’ve used hypnosis and a whole lot of other Western modalities. But I’ve found, for the people who come to me, who like me and kind of get on with or are interested in what I do, the combination of the Eastern and the Western is very powerful.

So, I bring Eastern philosophy in, and give them some homework to do around trying to understand some of the concepts that have been stored in Eastern culture, and about the nature of the self, the nature of the mind. Sort of, not, religious concepts, but philosophical or spiritual or meditative concepts.

And the combination of meditation and psychotherapy sort of speeds things up 100-fold, because meditation, you’re going home and doing the work on yourself, becoming your own therapist. You become empowered, and you become self-aware, and able to self-regulate, and that leads to self-mastery eventually. It takes a long time, in my opinion, to get to self-mastery. I think I’m still on my way to there, personally.

Dr. Ron Ehrlich: Yeah. Because it is so easy, and this is actually true of health care in general, to abdicate your responsibility to your health practitioner. I often say, “If the only thing you know is your doctor’s phone number, if the only thing you know about health is your doctor’s phone number, then you are in real trouble.” And I guess similarly, if you are relying totally on your psychotherapist for this service, then you’re in … well, trouble may be too strong a word, but you’re not fulfilling as much of the potential that you have as you would otherwise by harnessing that patient to be part of the process.

Dr. Shankardev Saraswati: The thing that brings people into psychotherapy is their inner child, mainly. Rare that an inner parent issue brings people to therapy, because, for various reasons, it’s complex. It’s mainly, we’re dealing with the inner child that somehow hasn’t been nourished.

So, you’ve got these two parts. One part of you generally, in the majority of people, is working pretty well in the world, and there’s another part that is kind of troublesome, internally troublesome. Worrying, anxiety, this constant production of thoughts, and worry, and anxiety, and feelings that are strange. You’re trying to avoid them with distraction, or alcohol, or something. But you’ve got a pretty functional life.

And so, that inner child would look to the therapist as a parent, or as an authority figure that could potentially fix them. And the thing about therapy is that you’re teaching people to become their own … to become an adult. To be able to stand on their two feet physically in the world, emotionally in the world, mentally, spiritually. To become a spiritual adult, an ethical adult.

Someone who can make decisions that aren’t always in their own best self-interest. Ultimately, these are very difficult areas to navigate, because it’s very complex. Sometimes we have to let go of a little bit of our own stuff, sacrifice a bit in order for the greater good.

So, that maturity, that maturation of the person is what the Eastern psychotherapies have always been about, and that’s always had a sort of guru-disciple, teacher-student relationship, which was very psychotherapeutic. I was in India for 10 years with my guru, and I wanted him to be my savior.

I wanted him to fix me. I wanted him to enlighten me. I wanted him to protect me from any problems, and I thought he was a god-man or something. And every time I tried to apply that in our relationship, he’d just knock me down. He’d say, “No, it’s up to you, what do you want to do? What’s right for you?” And just go back to the foundations, the knowledge, and apply and practice, and work it out for yourself.

But having that person there was an anchor. So, the Eastern psychotherapies have always had that, and a lot of practices, they have a tremendous number of practices and meditations and techniques that you can … There are techniques to work with your pelvis, there are techniques to work with your digestion, there are techniques to work with your heart, and your emotions, and your physical heart, and your psychological heart, or your metaphysical heart. There are techniques to work with the brain and intuition –

Dr. Ron Ehrlich: These techniques are practices?

Dr. Shankardev Saraswati: They’re all practices.

Dr. Ron Ehrlich: They’re all practices of breathing, meditation, focus?

Dr. Shankardev Saraswati: In the yoga traditions, they are postures, breathing, meditation, mantras, sound vibration, visualization combinations. It all comes back to self-awareness, the ability to focus your attention onto a part of your body and apply knowledge and energy for change or to understand what’s going on. Can I … How do I change this feeling? How do I change my digestion? What is my body telling me? How do I get to hear that more? It’s the relationship with self that is the key.

Dr. Ron Ehrlich: And I think last time we had a chat, you mentioned to me, or you just mentioned it before, that the meaning of yoga is connection, but the meaning of meditation is …?

Dr. Shankardev Saraswati: Connection.

Dr. Ron Ehrlich: Connection. Which I think is really …

Dr. Shankardev Saraswati: Yeah. Meditation requires three things: a meditator, an object of meditation, and the act of meditation, which connects the meditator with the object. And the object can be physical, it can be abstract, it can be self, it can be anything.

Dr. Ron Ehrlich: What’s an example of a physical object?

Dr. Shankardev Saraswati: Like a flower.

Dr. Ron Ehrlich: Just looking at something, a candle, or a sunflower

Dr. Shankardev Saraswati: A sunrise.

Dr. Ron Ehrlich: A sunrise. Just do that.

Dr. Shankardev Saraswati: Yeah.

Dr. Ron Ehrlich:  Another person.

Dr. Shankardev Saraswati: Yeah. So, when I’m with my patients, I’m meditating on my patients in a way that I’m aware of what’s going on in me. I’m trying to be fully aware of what’s going on in them. I want to be able to see them, hear them, feel them, experience them to a degree. What’s their trauma? The more information I get subliminally, or through the subconscious, that I can be aware of through my meditative practice, the more I hear beyond the words, and that’s the key. You want to hear beyond the verbal description. Because a lot of people are saying things, and then you can hear something else, and you say, “Well, what about this?”

Dr. Ron Ehrlich: In a sense, this is a meditation.

Dr. Shankardev Saraswati: Yes.

Dr. Ron Ehrlich: We are doing … This is a public meditation we’re in.

Dr. Shankardev Saraswati: It is. It’s a lively dynamic because we’re connected. So, yoga enables things to work. If there’s no yoga, if there’s no connection, things don’t work. So, whenever you’ve got a relationship, a marriage, where the two partners are not connected, they don’t have a yoga, they don’t have a union, they don’t have a connection.

In the couples work I do, which is rare but occasional, not my specialty, but I have done a bit, you try to get the couple to work out how to stay in this kind of harmonious tension, this peaceful tension. How to build, how to see each other anew, and how can we explore better connection? What works for me? What works for the other?

Dr. Ron Ehrlich: This word connection, because it’s a theme that runs through a lot of my podcast, and that is the connection that we have with the world, rather than just as an individual doing what we feel like doing because it gives us pleasure, this connection that we have with the rest of the world, and also now this connection we have with our bodies and our mind, it’s an important word.

We’ve talked about the power of meditation, and we’ve talked about the power of counseling. Now, we’ve just spent, you and I have just spent four days together on a program on nutritional and environmental medicine. What were some of the takeaways for you, as a psychotherapist, with your background and your practice? What were some of the … This was nutritional and environmental medicine, and how it impacts on our health.

Dr. Shankardev Saraswati: You know, this was a really wonderful weekend. It was a four-day weekend. And the thing that obviously I was able to relate to, or I could apply most readily, was the mental health part of it from a psychotherapeutic perspective. And it helped me to understand, for example, that if we can do some genetic testing, we can often get a sense of where the people, the metabolism of various parts of their body is working one way or another.

What’s coming out of the literature now is, say, 80 percent of the people that I’ve been working with did well if they needed antidepressants, which is occasional. It does happen. We have to use the best of everything. And another group of people that weren’t able to metabolize, or the antidepressants made them feel worse, they didn’t get a response. And so I’ve done some genetic testing on some of my clients after that weekend, and I found that in particular, one case that was very interesting, he had a certain genetic polymorphism, which is, we call it a “genetic boo-boo.”

Dr. Ron Ehrlich: A more technical term.

Dr. Shankardev Saraswati: Very technical. … Which prevented him from metabolizing neurotransmitters, so they block up. He gets this, it’s like a blockage in the –

Dr. Ron Ehrlich: In those live chemical pathways.

Dr. Shankardev Saraswati: In the cascade. And so you get this build up of other chemicals in the background. And so, for that particular group, according to the latest research that I’ve been reading, antidepressants are actually detrimental. So, we’re now moving him off those and onto certain supplements, zinc, B6, B3, and I think there’s some certain very rare form of B12.

Dr. Ron Ehrlich: An activated form of B12.

Dr. Shankardev Saraswati: It’s a hydroxy of B12.

Dr. Ron Ehrlich: Okay, let’s not get too … We’ve lost our audience. We’ve lost the whole audience here, but the point being that there were certain … You were looking at this from the point of view of, okay, there’s a biochemistry that goes into a mood, and if you’re unable to produce the nutrients that you need, sometimes that manifests itself as a mental health issue.

Dr. Shankardev Saraswati: Often.

Dr. Ron Ehrlich: Often. Not sometimes.

Dr. Shankardev Saraswati: Often what happens is, these things make us feel uncomfortable. The body’s talking to us. It’s saying, “You’re out of balance. You just don’t feel good. You’ve got no well-being.” And then in order to fix that, you might try and numb it by overeating, or by alcohol, or by going to movies, or running, or doing something healthy, or something unhealthy. But you’ve got to address the cause, otherwise, it’s this underlying, corrosive feeling, sort of a deep resonance that you’re feeling, your life is contained in this sort of lack of wellbeing.

I think that ACNEM course, the Australian College of Nutritional and Environmental Medicinecourse, was very useful, and obviously groundbreaking, because a lot of this stuff … Research is always ten years ahead of clinical work, and so a lot of this stuff still percolating into the medical system. There is a struggle within the Australian medical system, how to tail these things and stay within the government guidelines and so on. There was a lot of highlights for me from that course.

Dr. Ron Ehrlich: I mean, I think the –

Dr. Shankardev Saraswati: Also, I should say, the gut.

Dr. Ron Ehrlich: The gut. Huge.

Dr. Shankardev Saraswati: The gut, man.

Dr. Ron Ehrlich: What can’t you say about the gut? I mean, it’s everything.

Dr. Shankardev Saraswati: I love my poo.

Dr. Ron Ehrlich: Oh, well, let’s not go there.

Dr. Shankardev Saraswati: I like my poo, man.

Dr. Ron Ehrlich: No, but it’s true. The gut, not only the second brain, but it’s also where 80 percent of the immune system’s happening from. I mean, the gut and the whole microbiome. And I don’t think people really fully appreciate, and this is how we started this discussion, we were talking about a holistic approach to your practice, and this is why people tend to come in for … They come into a doctor’s surgery, and they’re depressed, and they get given an antidepressant. And there’s no exploration about what is going on biochemically, from a nutritional and environmental perspective, from a gut, or from a poo perspective, even, you know. It’s a really important message.

Dr. Shankardev Saraswati: But the problem here is that the way we’ve constructed our society, commercialization of food over the last two, three generations, and the sort of avalanche of diabetes, and the avalanche of metabolic diseases, heart disease and cancer and so on –

Dr. Ron Ehrlich: Autoimmune disease.

Dr. Shankardev Saraswati: Autoimmune.

Dr. Ron Ehrlich: Mental health.

Dr. Shankardev Saraswati: All with a very strong foundation in poor nutrition. Our soil’s depleted, the food no longer has micronutrients, so GPs are at the coal face. I have a very specialized general practice, and I may see 18 people a week. But a normal GP trying to handle the avalanche of stuff coming through, they’re just overwhelmed.

Dr. Ron Ehrlich: Absolutely, and in fact, I think that’s part of the problem with medicine, is that … Because every doctor I know, whether they’re practising at the coal face, writing out prescriptions to try and manage and control people’s chronic disease, or the integrative doctor who is doing the full workup of their nutritional background on a patient, the two things those practitioners have in common is they want the best for their patients. It’s just they’re approaching from a different angle.

But listen, it’s been terrific because we’ve covered a lot of territory here. I wanted to finish just by asking you, this is something I ask a lot of my guests, what do you think the biggest challenge is that people face today in the modern world on their health journey? What do you think that is?

The Biggest Health Challenge

Dr. Shankardev Saraswati: I think the biggest challenge is for people to take control of their own health. Partly because if we do a psychotherapeutic analysis of the system, the medical system is very paternalistic, and they infantilize the patients.

Dr. Ron Ehrlich: Make them feel …

Dr. Shankardev Saraswati: Make them feel –

Dr. Ron Ehrlich: Childlike.

Dr. Shankardev Saraswati: That they don’t know anything, and the doctor knows everything, and just follow my advice. And I think the key is education, and becoming empowered. I think it’s happening more and more, amongst the more educated clientele. They’re asking more questions. But as a general principle, get education around physical health. Get more education around psychological health.

The problem today, too, is that we live in a world of information, and information is not knowledge, and knowledge is not wisdom, as some wise person said. I think we’re bombarded with information, so it’s about talking with people over time, getting experience, talking to different practitioners, and reading, and so on, within whatever timeframe you can. Because we’re busy, but I think … The challenge is modern life itself. It’s just hard to hold it all together. But I think the work you’re doing with your podcast is a very good way to get the message out there, or our message, anyway.

Dr. Ron Ehrlich: Yeah, yeah, it’s a common theme. Thank you so much for joining me today.

Dr. Shankardev Saraswati: It’s a great pleasure, as always.

Conclusion

Dr. Ron Ehrlich: Well, connection is the key. The word yoga and meditation, as you heard, both mean connection, between the body and the mind. And of course, the mind and the body are intimately connected. I personally do a yoga practice every morning. I’ve done it for over 20 years.

It’s called the Salute to the Sun, and no matter how I feel, if I just do a few rounds of it, typically 6-10 rounds, I always feel better. It doesn’t take more than five minutes, but it makes such a difference. And if I do a workout, I incorporate it into the start of a workout. It’s an all-encompassing exercise. It’s fabulous, and I’ll put some of the info on the website or Facebook.

I also practice mindfulness, switching on the parasympathetic system, several times a day, and you can do that through just breath-holding. Breathing in slowly, breathing out slowly, and holding the breath. That simple act, and you only need to do it four or five times, switches on the parasympathetic nervous system, which is that rest and digest.

I’m working on the meditation part of my life. It’s a work in progress, to be honest, having had several occasions in my life where I found psychotherapy to be a great help…now, that is something that is very cathartic, just about giving voice to a feeling and finding the right person to guide you, and as Shankardev said, find that inner adult. That can be life-changing, and for some people, life-saving. Now, I’ll have a link to Shankardev’s website. He runs fantastic online courses and workshops, which I’d really recommend to you. Until next week, this is Dr. Ron Ehrlich. Be well.

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